| NPI | 1396295952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW RAFAEL EISEN Clinical Director 770-552-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR007877) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR009680) |
| 111N00000X Chiropractor (Licence: GA CHIR009709) | |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |